Depression, anxiety, posttraumatic stress disorder and perceived psychosocial care during hospital stay after myocardial infarction: a cross-sectional study

Depression, anxiety, posttraumatic stress disorder and perceived psychosocial care during hospital stay after myocardial infarction: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Depression, anxiety, posttraumatic stress disorder and perceived psychosocial care during hospital stay after myocardial infarction: a cross-sectional study Carolin Swoboda, Paul Gellert, Elisabeth Steinhagen-Thiessen, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6601928/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 08 Sep, 2025 Read the published version in BMC Cardiovascular Disorders → Version 1 posted 11 You are reading this latest preprint version Abstract Background: Myocardial infarctions (MI) significantly contribute to the global disease burden and are often followed by psychological conditions such as depression, anxiety, and posttraumatic stress disorder (PTSD). These are frequently underrecognized and insufficiently addressed in clinical care. This study aims to investigate the psychosocial impact of MI, identify risk factors for psychological burden following an MI, and gain insight into the perceived psychological care during hospitalization.​ Methods: A population-based online survey ( N =199 MI patients) was conducted between May 15th and August 1st, 2024. Standardized instruments included Depression Anxiety Stress Scale-21 (DASS-21), International Trauma Questionnaire (ITQ), Brief Illness Perception Questionnaire (B-IPQ), ENRICHD Social Support Inventory (ESSI), UCLA 3-Item Loneliness Scale, Brief Resilience Scale (BRS), and Stress-and Coping-Inventory (SCI). Multiple linear regression models examined associations between psychological burden, psychosocial factors, MI event characteristics, illness perception, history of illness, and perceived psychosocial care during hospitalization. Results: More than half (58.8%) of MI patients experienced at least one psychological burden, with 37.7% meeting criteria for depression, 46.2% for anxiety, and 18.6% for PTSD. Additionally, 65.9% reported not to be asked about their mental health during hospitalization. Depression was significantly associated with illness perception (β = .386), loneliness (β = .228) and age (β = -.125). Anxiety was associated with illness perception (β = .535), multiple MIs (β = .168), fear of death (β = .117), prior diagnosis of mental disorder (β = .113), resuscitation (β = -.108) and having no partner (β = -.105). PTSD was linked to illness perception (β = .371), age (β = -.157), fear of death (β = .148), multiple MIs (β = .122), loneliness (β = .149), and social support (β = -.139). Conclusion: The findings emphasize the psychological burden following MI and the need for their systematic screening in cardiology to improve patient care. cardiovascular disease heart attack psychosocial burden PTSD psychosocial care 1. Background Cardiovascular diseases (CVD) and mental disorders are major contributors to the global burden of disease in modern society [ 1 – 3 ]. Projections indicate that by 2030, both CVD and depression will be leading causes of disability worldwide [ 4 – 7 ]. Importantly, cardiovascular and mental health conditions are interlinked with a bidirectional, mutually reinforcing relationship [ 8 – 11 ]. Moreover, patients suffering from both CVD and mental disorders show increased health risks, which can lead to higher morbidity and mortality rates as well as lower quality of life [ 9 , 12 – 14 ]. Moreover, the psychological burden significantly impacts recovery, overall well-being, and secondary prevention efforts following MI [ 14 , 18 , 21 ]. Among patients with CVD, the prevalence of mental disorders—particularly depression and posttraumatic stress disorder (PTSD)—is notably high compared to the general population [ 5 , 11 , 15 – 17 ]. Studies suggest that depression is especially common within the first year after a myocardial infarction (MI), with prevalence estimates ranging from approximately 25–35.4% [ 18 , 19 ]. Similarly, PTSD is a significant concern with approximately 12% of patients with acute coronary syndrome exhibiting clinically relevant PTSD symptoms [ 17 ]. In contrast, the prevalence of anxiety disorders among cardiovascular patients is estimated at 15.5%, a rate comparable to that of the general population [ 15 , 20 ]. However, research on the association between anxiety and CVD remains less comprehensive, making direct comparisons of prevalence rates across studies challenging [ 21 – 25 ]. The reciprocal relationship between mental and cardiovascular health, and its importance for prevention and care, is recognized by the European Society of Cardiology's guidelines for the treatment of acute cardiovascular diseases. These guidelines recommend incorporating psychosocial factors into the management of acute cardiovascular conditions [ 26 ]. Despite this recognition and growing evidence of the psychological burden following MI, it still seems to be neglected in cardiovascular care. As a result, mental disorders are often inadequately screened, undiagnosed and untreated in this population [ 20 , 27 – 32 ]. Furthermore, current treatment approaches are often focusing primarily on the physical aspects of the disease, rather than the psychological burden [ 12 , 27 , 31 , 33 – 34 ]. Numerous studies identified associated factors of psychological burden following MI, e.g. younger age, female gender, and being unpartnered [ 35 – 39 ], as well as having a history of mental disorders [ 39 – 44 ] and multiple MIs in the past [ 40 ]. MI-related complications, such as resuscitation due to MI [ 39 , 41 , 42 , 44 ] has also been found to be linked to greater psychological distress. Additionally, a threatening perception of both heart disease and the MI event itself [ 42 – 48 ], along with psychosocial factors, such as loneliness, lack of social support, low resilience, and inadequate coping mechanisms, contribute to increased psychological burden following MI [ 35 , 39 , 49 – 59 ]. Despite the growing body of research, little is known about the co-occurrence of depression, anxiety and PTSD in CVD patients and how various factors are linked to these mental health outcomes. Moreover, it remains unclear to what extent psychosocial screening and mental health care are integrated into routine cardiovascular treatment. While psychosocial distress following MI is well documented, research on actual mental health care utilization and access to psychological support during hospitalization remains scarce. This study aims to investigate the psychosocial burden (depression, anxiety, PTSD) after MI and to examine psychosocial care during hospitalization. 2. Methods 2.1 Participants and Design This cross-sectional study was conducted via an online survey between May 15th and August 1st, 2024, in Germany. Eligible participants were adults who had experienced MI, recruited independently of their hospitalization and without restrictions on the time elapsed since the event. Recruitment was carried out through multiple channels, including social media, online forums, medical facilities affiliated with Charité – Universitätsmedizin Berlin, cardiology clinics, through outreach to sports and heart patient groups and the Deutsche Herzstiftung e.V. (German Heart Foundation), which disseminated study information via its communication channels. The survey was administered using the secure Research Electronic Data Capture (REDCap) platform. The questionnaire was accessed 399 times, with 199 participants completing it in full. Informed consent was obtained online, and the survey was conducted anonymously in accordance with ethical standards and regulations. The study was approved by the Ethics Committee of the Faculty of Medicine at Charité – Universitätsmedizin Berlin (EA2/052/24). 2.2 Measurements 2.2.1 Demographics The online survey collected sociodemographic data, including age, gender (being male, female, divers) and relationship status. 2.2.2 Depression, Anxiety and PTSD following MI Depression and anxiety were assessed using the Depression- and Anxiety-subscales of the Depression Anxiety Stress Scale-21 (DASS-21) [ 60 ]. Each subscale consists of 7 items, evaluated on a 4-point Likert scale, measuring the frequency or severity of the participants experiences over the last week. The final scores - ranging from 0 to 21 - were multiplied by two [ 61 ]. Established cutoff values classify depression scores of 9 or lower as ‘normal,’ 10–13 as ‘mild,’ 14–20 as ‘moderate,’ 21–27 as ‘severe,’ and 28 or higher as ‘extremely severe.’ Anxiety scores are categorized as ‘normal’ for values of 7 or lower, ‘mild’ for scores of 8–9, ‘moderate’ for 10–14, ‘severe’ for 15–19, and ‘extremely severe’ for 20 or higher [ 62 ]. While these categories provide a broader classification, for descriptive analyses in this study, a cut-off score corresponding to the ‘moderate’ category was applied for both depression and anxiety. Both subscales demonstrated strong internal consistencies in this study (Cronbach α = .94 in Depression Subscale, Cronbach α = .86 in Anxiety Subscale). PTSD was assessed using the International Trauma Questionnaire (ITQ) [ 63 ]. The ITQ consists of 9 items rated on a 5-point Likert scale (0 = "not at all" to 4 = "very strong") evaluating traumatic symptoms over the past month. For this study, participants rated all ITQ items specifically in relation to their MI experience, which was defined as the traumatic event. The ITQ measures symptoms of re-experiencing, avoidance, and perceived current threat, along with functional impairment. A PTSD diagnosis requires the endorsement of at least one symptom from each cluster plus one indicator of functional impairment. A dimensional analysis can be performed by summing the core symptom items, excluding those related to functional impairment [ 63 ]. The ITQ demonstrated high internal consistency (Cronbach α = .92) in this study. 2.2.3 History of Illness Participants were asked to indicate the timing of their first MI, with responses categorized into predefined time intervals ( 10 years ago). Additionally, they were asked whether they had experienced multiple MIs ("yes" or "no").. If multiple MIs were reported, participants were instructed to focus on the most severe MI in subsequent questions—defined as the MI causing the most emotional distress and life impact. Participants were also queried about any mental disorder history with the question, “Have you ever been diagnosed with a mental disorder by a qualified professional?” Response options were “Yes, before the (first) heart attack,” “Yes, after the (first) heart attack,” and “No”. 2.2.4 MI Event Characteristics Two items were developed to assess the event characteristics of (most impactful) MI. Participants were asked whether resuscitation was performed (“Yes” or “No”) and to rate their fear of death during MI on a 10-point scale (0 = "no fear" to 10 = "extreme fear"). 2.2.5 Illness Perception The Brief Illness Perception Questionnaire (B-IPQ) [ 63 ] was used to assess illness perception, with modifications to specifically address heart disease. The B-IPQ consists of 8 items rated on a 10-point scale, capturing cognitive and emotional representations of the illness and its perceived threat [ 64 ]. The B-IPQ is evaluated by summing the scores of all eight items, resulting in a total score between 0 and 80. For interpretation, the proposed thresholds were applied: <42 points indicate ‘low’, 42–49 points ‘moderate’, and ≥ 50 points ‘high’ threat perception [ 64 , 65 ]. The B-IPQ demonstrated an acceptable internal consistency (Cronbach α = .80) in this study. 2.2.6 Perceived psychosocial care during hospital stay after MI To evaluate psychosocial care during hospitalization by hospital staff, four items were developed: 1) “Did the hospital staff ask about your well-being or mental health?”, 2) “Did the hospital staff offered psychological support?”, 3) “Did the hospital staff inform about the possible psychological effects of a heart attack?”, 4) “Did the hospital staff give information about counselling services in case of mental distress?”. Response options were "Yes", "No" and "Not sure/unclear". 2.2.7 Psychosocial Factors Psychosocial factors were assessed using measures of social support, loneliness, resilience, and active coping strategies. Social support was measured using the ENRICHD Social Support Inventory (ESSI) [ 66 ], a five-item scale. A total score (5–25) is calculated, with ≤ 18 points or a response of ≤ 3 on at least two items indicating ‘low’ social support [ 67 ]. The ESSI demonstrated strong internal consistency (Cronbach α = .94) in this study. Loneliness was assessed using the UCLA 3-Item Loneliness Scale with scores (range: 3–9) categorized as low (3–5) or moderate to high (6–9) loneliness [ 68 – 70 ]. The Scale demonstrated good internal consistency (Cronbach α = .87) in this study. Resilience was measured using the Brief Resilience Scale (BRS), with six items rated on a five-point Likert scale [ 71 ]. Total scores were calculated as the mean (range: 1.00–5.00) and are categorizable into ‘low’ (1.00–2.99), ‘normal’ (3.00–4.30), or ‘high’ resilience (4.31–5.00) based on established cut-offs [ 72 ]. The BRS demonstrated a good internal consistency (Cronbach α = .84) in this study. Active coping strategies were assessed using the Active coping strategies subscale of the Stress and Coping Inventory (SCI) [ 73 , 74 ]. The raw item scores are summed (range: 4–16) and interpreted using the SCI manual's norm table. Scores of 4–6 indicate ‘low’, 7–10 ‘average’, and 11–16 ‘good’ active stress coping ability. The SCI demonstrated an acceptable internal consistency (Cronbach α = .76) in this study. 2.3 Statistical Analysis Descriptive statistics were computed for participant characteristics, including frequencies and percentages for categorical variables, and means and standard deviations for continuous variables. Normal distribution of the data was assessed using the Shapiro-Wilk test. As a result, relationships between anxiety, depression, PTSD, and categorical variables were examined using the Mann-Whitney U test and the Kruskal-Wallis test, as appropriate. Multiple regression analyses were conducted to identify factors associated with anxiety, depression, and PTSD following MI. Separate multiple linear regression models were fitted for each outcome (i.e. depression, anxiety, PTSD). To meet linearity assumption, dependent variables were log10-transformed (log10(variable + 1)). Assumptions of independence of residuals, multicollinearity, homoscedasticity, and normality of residuals were evaluated and met. Outliers were assessed using studentized residuals, leverage points, and Cook's distance, with no significant issues identified. Both unstandardized (B) and standardized (β) coefficients were reported to interpret the regression models. All analyses were performed using IBM SPSS Statistics for Windows, version 28.0 (IBM Corp., Armonk, NY). Statistical significance was set at p < 0.05. 3. Results 3.1 Sample characteristics and prevalence of Depression, Anxiety and PTSD after MI A total of N = 199 took part in the survey; 43.2% were female and 56.8% were male, with a mean (± SD ) age of 61.64 years (± 10.75). More than half (58.8%, n = 117) of the sample reported psychological distress, with 37.7% meeting the cut-off for depression, 46.2% for anxiety, and 18.6% for PTSD. Female participants were disproportionately affected across all categories (see Table 1). Participants with anxiety had the highest rates of being affected of multiple MI (19.6%), and the most pronounced fear of death during MI ( M = 7.84, SD = 2.41). Illness perception was high across all distressed participants, with participants with PTSD showing the highest perceived threat ( M = 53.30, SD = 9.67). Social support was lowest for participants with PTSD ( M = 16.03, SD = 6.02), while loneliness was highest for participants with depression ( M = 6.04, SD = 2.00). Resilience and active stress coping were low among all distressed participants. Overall, psychosocial care during hospital stay after MI care during hospitalization for MI was perceived as insufficient. Among all MI patients, 34.2% reported having been asked about their wellbeing / mental health by hospital staff (Depression: 28.0%, Anxiety: 21.7%, PTSD: 24.3%). 15.1% reported being offered psychological help by hospital staff (Depression: 13.3%, Anxiety: 13.0%, PTSD: 16.2%), and only 11.1% reported being informed about the potential psychological effects of MI by hospital staff (Depression: 10.7%, Anxiety: 7.6%, PTSD: 8.1%). Only 7.0% of the participants reported being informed about counselling services in case of mental distress for mental health by hospital staff (Depression: 5.3%, Anxiety: 5.4%, PTSD: 2.7%). In Terms of history of illness, 19.6% of all participants reported a diagnosis of a mental disorder prior MI, while 16.1% were diagnosed after MI. 64.3% reported no diagnosis of a mental disorder. Table I Characteristics of participants Total ( N = 199) Depression a ( n = 75) Anxiety b ( n = 92) PTSD c ( n = 37) n (%) n (%) n (%) n (%) Sociodemographics Sex Female 86 (43.2) 43 (57.3) 50 (54.3) 24 (64.9) Male 113 (56.8) 32 (42.7) 42 (45.7) 13 (35.1) Age in Years ( M , SD ) 61.64 (10.75) 60.17 (10.05) 58.77 (10.52) 58.89 (9.56) Relationship status No partner d 41 (20.6) 20 (26.7) 24 (26.0) 9 (25.0) Partnership / married 156 (78.3) 54 (72.0) 67 (72.8) 27 (75.0) No information 2 (1.0) 1 (1.3) 1 (1.1) 1 (2.4) MI a Event Characteristics Fear of death during MI e, f ( M , SD ) 6.10 (3.35) 6.84 (3.51) 7.84 (2.41) 7.62 (3.11) Resuscitation Yes 36 (18.1) 12 (16.0) 14 (15.2) 10 (27.0) No 163 (81.9) 63 (84.0) 78 (84.8) 27 (73.0) Illness perception (M, SD) g 42.96 (13.96) 52.41 (10.65) 52.37 (9.54) 53.30 (9.67) History of Illness Timing of first MI e 10 years ago 48 (24.1) 14 (18.7) 14 (15.2) 5 (13.5) Multiple MI e Yes 34 (17.1) 14 (18.7) 18 (19.6) 7 (18.9) No 165 (82.9) 61 (81.3) 74 (80.4) 30 (81.1) Diagnosis of mental disorder Before MI e 39 (19.6) 23 (30.7) 27 (29.3) 13 (35.1) After MI e 32 (16.1) 15 (20.0) 20 (21.7) 8 (21.6) No diagnosis 128 (64.3) 37 (49.3) 45 (48.9) 16 (43.2) Perceived psychosocial care during hospital stay after MI e Staff asked about wellbeing/ mental health Yes 68 (34.2) 21 (28.0) 20(21.7) 9 (24.3) No / Unclear 131 (65.9) 54 (72.0) 72 (78.3) 28 (75.7) Staff offered psychological help Yes 30 (15.1) 10 (13.3) 12 (13.0) 6 (16.2) No / Unclear 169 (84.9) 65 (86.7) 80 (87.0) 31 (83.8) Staff informed about the possible impact of MI e on mental health Yes 22 (11.1) 8 (10.7) 7 (7.6) 3 (8.1) No / Unclear 177 (88.9) 67 (89.3) 85 (92.4) 34 (91.9) Staff informed about counselling services in case of mental distress Yes 14 (7.0) 4 (5.3) 5 (5.4) 1 (2.7) No / Unclear 185 (92.9) 71 (94.7) 87 (94.6) 36 (97.3) Psychosocial variables Social support h ( M , SD ) 19.57 (5.53) 16.84 (6.70) 18.04 (5.62) 16.03 (6.02) Loneliness i ( M , SD ) 4.81 (1.98) 6.04 (2.00) 5.49 (1.95) 5.62 (1.74) Resilience j ( M , SD ) 2.99 (.92) 2.68 (.84) 2.61 (.73) 2.78 (.92) Active coping strategies k ( M , SD ) 11.08 (2.41) 10.88 (2.50) 11.03 (2.16) 10.87 (2.45) Depression, Anxiety, PTSD Depression Score ≥ 14 ( n , %) 75 (37.7) ( M , SD ) 11.39 (10.45) Anxiety Score ≥ 10 ( n , %) 92 (46.2) ( M , SD ) 10.77 (9.47) PTSD Fulfilling criteria ( n , %) 37 (18.6) Depression, Anxiety and/or PTSD 117 (58.8) Notes . M = Mean; SD = Standard deviation. a Depression assessed with depression scale of DASS-21; Score ≥ 14 (moderate depression). b assessed with anxiety scale of DASS-21; Score ≥ 10 (moderate anxiety). c assessed with ITQ. d Single, divorced, widowed. e Myocardial infarction. f scale ranging from 0 to 10, higher scores indicating a greater fear of death during MI; g assessed with BIP-Q. h assessed with ESSI. I assessed with UCLA 3-Item Loneliness Scale. j assessed with BRS. k assessed with SCI. 3.2 Relationship between Depression, Anxiety, PTSD after MI and characteristics of participants The results of the Mann-Whitney U test indicate significant gender differences in depression, anxiety, and PTSD (see Table 2) . Female participants reported significantly higher levels of depression ( p < .001), anxiety ( p < .001) and PTSD ( p < .001) compared to male participants. Additionally, unpartnered individuals exhibited significantly ( p < .05) higher scores in depression compared to those in relationships. Regarding the perceived psychosocial care during hospital stay after MI, the analysis revealed that individuals who were asked about their wellbeing / mental health showed significantly lower levels in depression ( p < .05), anxiety ( p < .001) and PTSD ( p < .001) than those who were not asked. Finally, Individuals with a diagnosis of a mental disorder prior to their MI showed higher levels in depression ( p < .001), anxiety ( p < .001) and PTSD ( p < .001) than those diagnosed after the infarction or those without a psychological diagnosis. Table II Relationship between psychosocial burden and characteristics of participants Depression Anxiety PTSD Mdn (IQR) M-W p Mdn (IQR) M-W p Mdn (IQR) M-W p Sociodemographics Sex Female 12.0 (17.0) < .001 10.0 (15.0) < .001 8.0 (10.25) < .001 Male 6.0 (14.0) 6.0 (11.5) 3.0 (8.0) Relationship status No partner 12.0 (23.0) < .05 10.0 (19.0) .25 8.0 (8.75) .06 Partnership / married 8.0 (14.0) 8.0 (14.0) 4.0 (9.5) MI a Event Characteristics Resuscitation Yes 7.0 (17.0) .87 6.0 (13.5) .45 6.5 (12.0) .46 No 10.0 (16.0) 8.0 (14.0) 5.0 (9.0) History of Illness Multiple MI a Yes 11.0 (20.0) .55 11.0 (16.0) .18 10.0 (12.0) .18 No 8.0 (16.0) 8.0 (14.0) 4.0 (9.0) Diagnosis of mental disorder Before MI a 17.0 (18.5) < .001 17.0 (18.5) < .001 10.0 (12.0) < .001 After MI a or No diagnosis 8.0 (14.0) 8.0 (12.0) 4.0 (9.0) Perceived psychosocial care during hospital stay after MI a Staff asked about wellbeing/ mental health Yes 6.0 (15.5) < .05 6.0 (8.0) < .001 2.0 (9.25) .99 No / Unclear 10.0 (16.0) 8.0 (14.0) 6.0 (9.0) Staff informed about the possible impact of MI a on mental health Yes 4.0 (14.0) .14 4.0 (8.0) .06 2.0 (3.0) .12 No / Unclear 10.0 (16.0) 8.0 (15.5) 6.0 (10.50) Staff informed about counselling services in case of mental distress Yes 2.0 (16.0) .09 5.0 (10.5) .22 2.0 (4.0) .08 No / Unclear 10.0 (16.0) 8.0 (16.0) 6.0 (10.50) Notes . M-W p = significance of Mann-Whitney U test; Mdn = Median; IQR = interquartile range. Significant results are in bold. a MI = myocardial infarction. 3.3 Multivariate associations between characteristics of participants and depression, anxiety and PTSD after MI To evaluate the relationships between characteristics of participants and the psychological burdens after MI, multiple linear regression models were conducted (see Table 3). For depression, the multiple linear regression model explained 51.3% of the variance ( R² = .513), with an adjusted R² of 46.9%. The model showed significant associations with depression ( F [16, 180] = 11.827, p < .001). Illness perception had the strongest association ( β = .386, B = .014, p < .001). Loneliness ( β = .228, B = .059, p < .01) and age ( β = − .125, B = − .006, p < .05) were also significantly associated. For anxiety, the regression model accounted for 58.8% of the variance ( R² = .588), with an adjusted R² of 55.2%. The model indicated significant associations with anxiety ( F [16, 180] = 16.076, p < .001). Illness perception emerged as the strongest association ( β = .535, B = .018, p < .001). Fear of death during MI ( β = .117, B = .024, p < .001) and experiencing multiple MIs ( β = .168, B = .139, p < .01) were also significant. Diagnosis of mental disorder before MI and resuscitation were also significantly associated to anxiety ( β = .113, B = .131, p < .05; β = − .108, B = − .127, p < .05). Being unpartnered was also significantly associated with anxiety after MI ( β = − .105, B = − .118, p < .05). For PTSD, the model explained 58.4% of the variance ( R² = .584), with an adjusted R² of 54.7%. Illness perception had the strongest association ( β = .371, B = .012, p < .001). Age ( β = − .157, B = − .006, p < .01), loneliness ( β = .149, B = .033, p < .05), and fear of death during MI ( β = .148, B = .019, p < .01) were also significantly associated to PTSD. Respectively social support ( β = − .139, B = − .011, p < .05) was negatively associated with PTSD and multiple MI ( β = .122, B = .140, p < .01) was positively associated with PTSD. Table III Multiple linear Regression analysis on Depression (D-DASS-21), Anxiety (A-DASS-21) and PTSD (ITQ) Depression Anxiety PTSD B CI (B) β B CI (B) β B CI (B) β (Intercept) .803* [.09, 1.52] .425 [-.17, 1.02] .586* [.02, 1.15] Sociodemographics Age − .006* [-.01, .00] − .125* − .004 [-.01, .00] − .097 − .006** [-.01, − .00] − .157** Sex (female) .018 [-.10, .14] .018 − .014 [-.11, .08] − .016 − .003 [-.10, .09] − .003 Relationship status (no partner) − .081 [-.22, .06] − .065 − .118* [-.24, − .00] − .105* − .054 [-.16, .06] − .050 MI a Event Characteristics Fear of death during MI a − .006 [-.02, .01] − .039 .024** [.01, .04] .177** .019** [.01, .03] .148** Resuscitation (Yes) − .093 [-.24, .05] − .071 − .127* [-.25, − .01] − .108* − .031 [-.14, .08] − .027 Perceived psychosocial care during hospital stay after MI a Staff asked about wellbeing/ mental health (Yes) .026 [-.10, .15] .024 − .061 [-.17, .04] − .064 − .094 [-.19, .00] − .104 Staff offered psychological help (Yes) − .065 [-.26, .13] − .046 .035 [-.12, .19] .027 .093 [-.06, .24] .078 Staff informed about the possible impact of MI a on mental health (Yes) .137 [-.10, .37] .083 .040 [-.15, .23] .027 .077 [-.11, .26] .055 Staff informed about counselling services in case of mental distress (Yes) − .186 [-.46, .09] − .094 .001 [-.23, .23] .001 − .165 [-.38, .05] − .098 History of Illness Multiple MIs a (Yes) .117 [-.02, .22] .087 .168** [.05, .29] .139** .140** [.03, .26] .122** Diagnosis of mental disorder before MI a (Yes) .046 [-.10, .19] .036 .131* [.01, .25] .113* .062 [-.05, .18] .057 Illness Perception of heart disease .014*** [.01, .02] .386*** .018*** [.01, .02] .535*** .012*** [.01, .02] .371*** Psychosocial factors Social support − .012 [-.03, .00] − .128 − .008 [-.02, .00] − .097 − .011* [-.02, − .00] − .139* Loneliness .059** [.02, .10] .228** − .008 [-.04, .02] − .033 .033* [.00, .06] .149* Resilience − .013 [-.03, .00] − .121 − .009 [-.02, .00] − .099 − .009 [-.02, .00] − .099 Active coping strategies .002 [-.02, .03] .011 .016 [-.00, .03] .084 .010 [-.01, .03] .057 R 2 (adjusted R 2 ) .513 (.469) .588 (.552) .584 (.547) Notes . Model = "Inclusion" method in SPSS Statistics; B = Non-standard regression coefficient. CI (B) = 95% confidence interval for B; The CI was rounded to the second decimal place; SE(B) = standard error of coefficient B; β = standardised coefficient; Depression, Anxiety, PTSD: log10-transformed; *p < .05. **p < .01. ***p < .001. a MI = myocardial infarction. 4. Discussion The present study aimed to investigate the psychological burden of MI, identify associated factors for depression, anxiety, and PTSD, and gain insights into the perceived psychosocial care during hospital stay after MI. The findings revealed that more than half of the participants suffer from depression, anxiety, and/or PTSD. Still, only up to one third of participants received psychosocial care during hospitalization. Multivariate analysis showed that a threatening illness perception was associated with depression, anxiety, and PTSD. Additionally, younger age and loneliness were linked to depression and PTSD, while multiple MIs and fear of death were associated with anxiety and PTSD. Anxiety was further related to a history of mental disorders, no resuscitation, and being with no partner, whereas PTSD was significantly associated with low social support. The prevalence rates of the psychological burden observed in the present sample were higher than in previous research [ 5 , 11 , 15 , 17 – 20 ], particularly for depression and anxiety. This discrepancy may have occurred due to differences in assessment timing, as prior studies often collected data during hospitalization [e.g. 18], whereas this study recruited participants online with varying MI histories. Factors such as differences in assessment methods, sample characteristics (e.g., age distribution, socioeconomic status, and pre-existing mental health conditions) or the possibility of prolonged psychological distress accumulation, may explain the higher prevalence found. Regarding sociodemographic factors, age was negatively associated with depression and PTSD, suggesting a greater psychological burden in younger individuals. A possible explanation for this finding is that younger individuals are less prepared to cope with serious health events like MI, and may experience heightened existential anxiety related to career, family, or future plans, which could exacerbate psychological distress. Moreover, being without a partner also emerged as an important factor, significantly associated with anxiety after MI. The absence of a partner may contribute to an increased psychological burden due to reduced emotional and practical support in coping with different (life-threatening) events. This finding aligns with the broader pattern observed in this study, where social factors play a crucial role in psychological burden. While these findings are in line with prior research [ 35 , 37 , 39 , 49 – 51 ], other psychosocial factors such as resilience and active stress coping did not show significant association with the psychological burden compared to prior research [ 53 – 59 ]. Further, a threatening illness perception was significantly associated with psychological burden after MI, while fear of death was significantly linked to anxiety. These associations align with findings widely discussed in the literature, underscoring the crucial role of subjective perceptions of illness severity in shaping psychological outcomes following MI [ 42 – 48 ]. An unexpected finding of the present study was that participants who did not underwent resuscitation exhibit significantly higher anxiety than those who underwent resuscitation, contradicting the findings of prior studies [ 40 ]. A possible explanation could be that resuscitated patients received more intensive care and post-event monitoring, providing reassurance and potentially reducing anxiety. Additionally, the extreme nature of resuscitation might have prompted more social support. In contrast, patients who did not undergo resuscitation may have experienced greater uncertainty and received less social support, leading to higher anxiety. This highlights the need for psychological screenings in all MI patients, not just those with severe medical conditions requiring resuscitation. Consistent with previous research [ 39 , 41 , 42 ], a history of mental disorders prior to MI was found to be a significant factor for anxiety after MI. Moreover, despite the high prevalence of psychological burden, most participants lacked an official diagnosis, suggesting that the mental health of cardiac patients might be often overlooked. In addition to these findings, only a small proportion of participants reported to have received psychosocial care during hospitalization, which is in line with previous research [ 12 , 20 , 26 – 34 ]. While about one third of participants stated that staff asked about wellbeing / mental health further psychosocial support—such as offering of psychological help, information on the psychological impact of MI, and information about counselling services in case of psychological distress—were even more infrequent. Finally, the analysis of the relationship between depression, anxiety, PTSD and the characteristics of the participants revealed a significant difference between individuals who were asked about their mental health during the hospital stay and those who were not. Specifically, those who received such an inquiry reported lower levels of depression, anxiety, and PTSD. However, multivariate analysis found no significant impact of psychosocial care during hospitalization on psychological burden. 4.1 Limitations This study has several limitations that should be considered. The cross-sectional design provides only a snapshot of individuals' mental health, limiting the ability to draw conclusions about long-term effects or developmental trajectories. As a result, the findings reflect associations rather than causal relationships. Additionally, the reliance on self-reported data introduces potential biases, such as social desirability effects and recall inaccuracies, which may affect the reliability of the responses. The limited sample size may also lead to underrepresentation of certain population subgroups, limiting the generalizability of the results. Moreover, participants with a history of multiple MIs were instructed to focus on the most severe event. While this approach was intended to capture the most intense psychological responses—acknowledging the significant role of subjective experience in conditions like depression, anxiety, and PTSD— it may have introduced inconsistencies in data collection. Since participants could select different reference points (e.g., the first MI vs. the most severe MI in case of multiple Mis in the past), this variability could affect comparability across individuals and potentially influence the overall findings. Using a standardized reference point, such as consistently analyzing the first MI, might have yielded different results. Despite these constraints, the study provides valuable insights into the psychological impact of MI and highlights the significance of subjective experiences in understanding mental health outcomes. Future research using longitudinal designs and additional clinical assessments could strengthen these findings and offer a more comprehensive understanding of mental health trajectories in this population. 4.2 Conclusion In summary, this study highlights the significant psychological burden experienced by individuals following MI, particularly in terms of depression, anxiety, and PTSD. These findings emphasize the need for more comprehensive psychosocial support during hospitalization, addressing not only the psychological aspects of recovery but also the social and demographic factors that contribute to mental health outcomes. The study underscores the importance of integrating mental health care into routine cardiovascular treatment, as recommended by the European Society of Cardiology. Early identification and management of psychosocial distress, including targeted interventions for factors such as loneliness, illness perception, and pre-existing mental health conditions, are essential for improving both psychological and medical recovery. These insights contribute to the growing understanding of the cardiovascular-mental health connection and provide a foundation for developing more holistic and effective care strategies moving forward. Abbreviations BIP-Q Brief Illness Perception Questionnaire BRS Brief Resilience Scale CVD Cardiovascular Disorders ESSI ENRICHD Social Support Inventory ITQ International Trauma Questionnaire IQR Interquartile range M Mean M-W Mann-Whitney-U-Test Mdn Median MI Myocardial Infarction PTSD Posttraumatic Stress Disorder REDCap Research Electronic Data Capture SCI Stress-and Coping-Inventory SD Standard Deviation Declarations Ethics approval and consent to participate The online survey was approved by the ethics committee of the Faculty of Medicine of the Charité – Universitätsmedizin Berlin (reference number: EA2/052/24). The study adhered to the Declaration of Helsinki. All data were provided and analyzed anonymously. All respondents provided written informed consent for participation. Clinical Trial number Not applicable. Consent for publication Not applicable. Availability of data and materials The dataset of the survey is available from the corresponding author on reasonable request. Competing Interests No competing interests declared. Funding The study was conducted at the Friede Springer – Cardiovascular Prevention Center (FS-CPC) which is funded by the Friede Springer Foundation (https://www.friedespringerstiftung.de/). The source has no implications for the conduct, and the results reported in this study. Authors' contributions The authors contributed to the article as follows: CS curated, analyzed the data, interpreted and visualized the data and wrote the main manuscript text. CS and CH developed the methodology, implemented software, and led the project administration. PG, EST, UL, MR, and SD assisted with supervision and resources. All authors contributed to initial draft of the manuscript and have approved the final version of the manuscript. Acknowledgements The authors thank all survey participants and the German Heart Foundation (Deutsche Herzstiftung e.V.) for supporting the study. References Benziger CP, Roth GA, Moran AE. 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Stress- und Coping-Inventar (SCI): Test- und Skalendokumentation (2., überarbeitete und neunormierte Version). 2024. Available online: https://www.drsatow.de/tests/stress-und-copinginventar/. Satow L. Stress- und Coping-Inventar (SCI): Testmanual und Normen (2., überarbeitete und neunormierte Version). 2024. Available online: https://www.drsatow.de/tests/stress-und-coping-inventar/ Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6601928","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":464092521,"identity":"ab546da4-a71e-463d-9673-c0cef4c67d3b","order_by":0,"name":"Carolin Swoboda","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDUlEQVRIiWNgGAWjYLCCBwZgig2E5BgkgMwEEP8AHi0JSFqMIVoSCGlhQGhJbJCACeHQwt9+9uGDhII7DPIzko89+FBml94/u/nZh4c/bBj4jjdg1SJxJt3YIMHgGYPBjbR0wxnnknNn3DlmPCMhIY1B8gx2awwY0tgkEgwOMxhI55hJ87Yx526QSDAG+gUociMBuxb+ZxAt8rPBWurTDSTSPwO1/GcwuP8AuxYJqC0Mt8FaDicYSOSAbDkAtAW79yVuPGMG+uUwj8H9ZyC/HDeccSOnmCEhLZlH8gx2h/H3pzE++PDnsJx8z2FQiFXL889I38z4w8ZOju84du/DAA8RIqNgFIyCUTAKiAYAiNBdAsx11YIAAAAASUVORK5CYII=","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":true,"prefix":"","firstName":"Carolin","middleName":"","lastName":"Swoboda","suffix":""},{"id":464092523,"identity":"258a0be0-1bdb-4af2-994a-5f2a43c509e8","order_by":1,"name":"Paul Gellert","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Paul","middleName":"","lastName":"Gellert","suffix":""},{"id":464092526,"identity":"56758141-d5fa-464a-b5a9-055f182d658a","order_by":2,"name":"Elisabeth Steinhagen-Thiessen","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Elisabeth","middleName":"","lastName":"Steinhagen-Thiessen","suffix":""},{"id":464092528,"identity":"f281e022-3ecc-4486-818f-88dad83e9ad4","order_by":3,"name":"Ulf Landmesser","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Ulf","middleName":"","lastName":"Landmesser","suffix":""},{"id":464092530,"identity":"abec5da9-0fd0-4c61-9882-488d842bfa90","order_by":4,"name":"Michael A. Rapp","email":"","orcid":"","institution":"University of Potsdam","correspondingAuthor":false,"prefix":"","firstName":"Michael","middleName":"A.","lastName":"Rapp","suffix":""},{"id":464092533,"identity":"35dbb61d-a11a-4316-9107-1f931ce3b9bd","order_by":5,"name":"Sandra Düzel","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Sandra","middleName":"","lastName":"Düzel","suffix":""},{"id":464092534,"identity":"7efb77a5-22c9-45c7-a269-f4337a18d675","order_by":6,"name":"Christian Hering","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Christian","middleName":"","lastName":"Hering","suffix":""}],"badges":[],"createdAt":"2025-05-06 10:23:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6601928/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6601928/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12872-025-05129-1","type":"published","date":"2025-09-08T15:57:16+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":91359058,"identity":"583c71d0-1663-4204-a4cb-d29f61d515b4","added_by":"auto","created_at":"2025-09-15 16:04:40","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1575140,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6601928/v1/f1202cef-00ba-4a11-bdad-bb2a22f66468.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Depression, anxiety, posttraumatic stress disorder and perceived psychosocial care during hospital stay after myocardial infarction: a cross-sectional study","fulltext":[{"header":"1. Background","content":"\u003cp\u003eCardiovascular diseases (CVD) and mental disorders are major contributors to the global burden of disease in modern society [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Projections indicate that by 2030, both CVD and depression will be leading causes of disability worldwide [\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Importantly, cardiovascular and mental health conditions are interlinked with a bidirectional, mutually reinforcing relationship [\u003cspan additionalcitationids=\"CR9 CR10\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Moreover, patients suffering from both CVD and mental disorders show increased health risks, which can lead to higher morbidity and mortality rates as well as lower quality of life [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Moreover, the psychological burden significantly impacts recovery, overall well-being, and secondary prevention efforts following MI [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Among patients with CVD, the prevalence of mental disorders\u0026mdash;particularly depression and posttraumatic stress disorder (PTSD)\u0026mdash;is notably high compared to the general population [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Studies suggest that depression is especially common within the first year after a myocardial infarction (MI), with prevalence estimates ranging from approximately 25\u0026ndash;35.4% [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Similarly, PTSD is a significant concern with approximately 12% of patients with acute coronary syndrome exhibiting clinically relevant PTSD symptoms [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. In contrast, the prevalence of anxiety disorders among cardiovascular patients is estimated at 15.5%, a rate comparable to that of the general population [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. However, research on the association between anxiety and CVD remains less comprehensive, making direct comparisons of prevalence rates across studies challenging [\u003cspan additionalcitationids=\"CR22 CR23 CR24\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The reciprocal relationship between mental and cardiovascular health, and its importance for prevention and care, is recognized by the European Society of Cardiology's guidelines for the treatment of acute cardiovascular diseases. These guidelines recommend incorporating psychosocial factors into the management of acute cardiovascular conditions [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Despite this recognition and growing evidence of the psychological burden following MI, it still seems to be neglected in cardiovascular care. As a result, mental disorders are often inadequately screened, undiagnosed and untreated in this population [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan additionalcitationids=\"CR28 CR29 CR30 CR31\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Furthermore, current treatment approaches are often focusing primarily on the physical aspects of the disease, rather than the psychological burden [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Numerous studies identified associated factors of psychological burden following MI, e.g. younger age, female gender, and being unpartnered [\u003cspan additionalcitationids=\"CR36 CR37 CR38\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], as well as having a history of mental disorders [\u003cspan additionalcitationids=\"CR40 CR41 CR42 CR43\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] and multiple MIs in the past [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. MI-related complications, such as resuscitation due to MI [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] has also been found to be linked to greater psychological distress. Additionally, a threatening perception of both heart disease and the MI event itself [\u003cspan additionalcitationids=\"CR43 CR44 CR45 CR46 CR47\" citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], along with psychosocial factors, such as loneliness, lack of social support, low resilience, and inadequate coping mechanisms, contribute to increased psychological burden following MI [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan additionalcitationids=\"CR50 CR51 CR52 CR53 CR54 CR55 CR56 CR57 CR58\" citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Despite the growing body of research, little is known about the co-occurrence of depression, anxiety and PTSD in CVD patients and how various factors are linked to these mental health outcomes. Moreover, it remains unclear to what extent psychosocial screening and mental health care are integrated into routine cardiovascular treatment. While psychosocial distress following MI is well documented, research on actual mental health care utilization and access to psychological support during hospitalization remains scarce. This study aims to investigate the psychosocial burden (depression, anxiety, PTSD) after MI and to examine psychosocial care during hospitalization.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Participants and Design\u003c/h2\u003e \u003cp\u003eThis cross-sectional study was conducted via an online survey between May 15th and August 1st, 2024, in Germany. Eligible participants were adults who had experienced MI, recruited independently of their hospitalization and without restrictions on the time elapsed since the event. Recruitment was carried out through multiple channels, including social media, online forums, medical facilities affiliated with Charit\u0026eacute; \u0026ndash; Universit\u0026auml;tsmedizin Berlin, cardiology clinics, through outreach to sports and heart patient groups and the Deutsche Herzstiftung e.V. (German Heart Foundation), which disseminated study information via its communication channels. The survey was administered using the secure Research Electronic Data Capture (REDCap) platform. The questionnaire was accessed 399 times, with 199 participants completing it in full. Informed consent was obtained online, and the survey was conducted anonymously in accordance with ethical standards and regulations. The study was approved by the Ethics Committee of the Faculty of Medicine at Charit\u0026eacute; \u0026ndash; Universit\u0026auml;tsmedizin Berlin (EA2/052/24).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Measurements\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 Demographics\u003c/h2\u003e \u003cp\u003eThe online survey collected sociodemographic data, including age, gender (being male, female, divers) and relationship status.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2 Depression, Anxiety and PTSD following MI\u003c/h2\u003e \u003cp\u003eDepression and anxiety were assessed using the Depression- and Anxiety-subscales of the Depression Anxiety Stress Scale-21 (DASS-21) [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. Each subscale consists of 7 items, evaluated on a 4-point Likert scale, measuring the frequency or severity of the participants experiences over the last week. The final scores - ranging from 0 to 21 - were multiplied by two [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. Established cutoff values classify depression scores of 9 or lower as \u0026lsquo;normal,\u0026rsquo; 10\u0026ndash;13 as \u0026lsquo;mild,\u0026rsquo; 14\u0026ndash;20 as \u0026lsquo;moderate,\u0026rsquo; 21\u0026ndash;27 as \u0026lsquo;severe,\u0026rsquo; and 28 or higher as \u0026lsquo;extremely severe.\u0026rsquo; Anxiety scores are categorized as \u0026lsquo;normal\u0026rsquo; for values of 7 or lower, \u0026lsquo;mild\u0026rsquo; for scores of 8\u0026ndash;9, \u0026lsquo;moderate\u0026rsquo; for 10\u0026ndash;14, \u0026lsquo;severe\u0026rsquo; for 15\u0026ndash;19, and \u0026lsquo;extremely severe\u0026rsquo; for 20 or higher [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e]. While these categories provide a broader classification, for descriptive analyses in this study, a cut-off score corresponding to the \u0026lsquo;moderate\u0026rsquo; category was applied for both depression and anxiety. Both subscales demonstrated strong internal consistencies in this study (Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.94 in Depression Subscale, Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.86 in Anxiety Subscale).\u003c/p\u003e \u003cp\u003ePTSD was assessed using the International Trauma Questionnaire (ITQ) [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. The ITQ consists of 9 items rated on a 5-point Likert scale (0 = \"not at all\" to 4 = \"very strong\") evaluating traumatic symptoms over the past month. For this study, participants rated all ITQ items specifically in relation to their MI experience, which was defined as the traumatic event. The ITQ measures symptoms of re-experiencing, avoidance, and perceived current threat, along with functional impairment. A PTSD diagnosis requires the endorsement of at least one symptom from each cluster plus one indicator of functional impairment. A dimensional analysis can be performed by summing the core symptom items, excluding those related to functional impairment [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. The ITQ demonstrated high internal consistency (Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.92) in this study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.2.3 History of Illness\u003c/h2\u003e \u003cp\u003eParticipants were asked to indicate the timing of their first MI, with responses categorized into predefined time intervals (\u0026lt;\u0026thinsp;1 year ago, 1\u0026ndash;5 years ago, 6\u0026ndash;10 years ago, and \u0026gt;\u0026thinsp;10 years ago). Additionally, they were asked whether they had experienced multiple MIs (\"yes\" or \"no\").. If multiple MIs were reported, participants were instructed to focus on the most severe MI in subsequent questions\u0026mdash;defined as the MI causing the most emotional distress and life impact. Participants were also queried about any mental disorder history with the question, \u0026ldquo;Have you ever been diagnosed with a mental disorder by a qualified professional?\u0026rdquo; Response options were \u0026ldquo;Yes, before the (first) heart attack,\u0026rdquo; \u0026ldquo;Yes, after the (first) heart attack,\u0026rdquo; and \u0026ldquo;No\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.2.4 MI Event Characteristics\u003c/h2\u003e \u003cp\u003eTwo items were developed to assess the event characteristics of (most impactful) MI. Participants were asked whether resuscitation was performed (\u0026ldquo;Yes\u0026rdquo; or \u0026ldquo;No\u0026rdquo;) and to rate their fear of death during MI on a 10-point scale (0 = \"no fear\" to 10 = \"extreme fear\").\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.2.5 Illness Perception\u003c/h2\u003e \u003cp\u003eThe Brief Illness Perception Questionnaire (B-IPQ) [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e] was used to assess illness perception, with modifications to specifically address heart disease. The B-IPQ consists of 8 items rated on a 10-point scale, capturing cognitive and emotional representations of the illness and its perceived threat [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]. The B-IPQ is evaluated by summing the scores of all eight items, resulting in a total score between 0 and 80. For interpretation, the proposed thresholds were applied: \u0026lt;42 points indicate \u0026lsquo;low\u0026rsquo;, 42\u0026ndash;49 points \u0026lsquo;moderate\u0026rsquo;, and \u0026ge;\u0026thinsp;50 points \u0026lsquo;high\u0026rsquo; threat perception [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]. The B-IPQ demonstrated an acceptable internal consistency (Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.80) in this study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e2.2.6 Perceived psychosocial care during hospital stay after MI\u003c/h2\u003e \u003cp\u003eTo evaluate psychosocial care during hospitalization by hospital staff, four items were developed: 1) \u0026ldquo;Did the hospital staff ask about your well-being or mental health?\u0026rdquo;, 2) \u0026ldquo;Did the hospital staff offered psychological support?\u0026rdquo;, 3) \u0026ldquo;Did the hospital staff inform about the possible psychological effects of a heart attack?\u0026rdquo;, 4) \u0026ldquo;Did the hospital staff give information about counselling services in case of mental distress?\u0026rdquo;. Response options were \"Yes\", \"No\" and \"Not sure/unclear\".\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e2.2.7 Psychosocial Factors\u003c/h2\u003e \u003cp\u003ePsychosocial factors were assessed using measures of social support, loneliness, resilience, and active coping strategies. Social support was measured using the ENRICHD Social Support Inventory (ESSI) [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e], a five-item scale. A total score (5\u0026ndash;25) is calculated, with \u0026le;\u0026thinsp;18 points or a response of \u0026le;\u0026thinsp;3 on at least two items indicating \u0026lsquo;low\u0026rsquo; social support [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e]. The ESSI demonstrated strong internal consistency (Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.94) in this study. Loneliness was assessed using the UCLA 3-Item Loneliness Scale with scores (range: 3\u0026ndash;9) categorized as low (3\u0026ndash;5) or moderate to high (6\u0026ndash;9) loneliness [\u003cspan additionalcitationids=\"CR69\" citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e]. The Scale demonstrated good internal consistency (Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.87) in this study. Resilience was measured using the Brief Resilience Scale (BRS), with six items rated on a five-point Likert scale [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]. Total scores were calculated as the mean (range: 1.00\u0026ndash;5.00) and are categorizable into \u0026lsquo;low\u0026rsquo; (1.00\u0026ndash;2.99), \u0026lsquo;normal\u0026rsquo; (3.00\u0026ndash;4.30), or \u0026lsquo;high\u0026rsquo; resilience (4.31\u0026ndash;5.00) based on established cut-offs [\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]. The BRS demonstrated a good internal consistency (Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.84) in this study. Active coping strategies were assessed using the Active coping strategies subscale of the Stress and Coping Inventory (SCI) [\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]. The raw item scores are summed (range: 4\u0026ndash;16) and interpreted using the SCI manual's norm table. Scores of 4\u0026ndash;6 indicate \u0026lsquo;low\u0026rsquo;, 7\u0026ndash;10 \u0026lsquo;average\u0026rsquo;, and 11\u0026ndash;16 \u0026lsquo;good\u0026rsquo; active stress coping ability. The SCI demonstrated an acceptable internal consistency (Cronbach \u003cem\u003eα\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.76) in this study.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Statistical Analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics were computed for participant characteristics, including frequencies and percentages for categorical variables, and means and standard deviations for continuous variables. Normal distribution of the data was assessed using the Shapiro-Wilk test. As a result, relationships between anxiety, depression, PTSD, and categorical variables were examined using the Mann-Whitney U test and the Kruskal-Wallis test, as appropriate. Multiple regression analyses were conducted to identify factors associated with anxiety, depression, and PTSD following MI. Separate multiple linear regression models were fitted for each outcome (i.e. depression, anxiety, PTSD). To meet linearity assumption, dependent variables were log10-transformed (log10(variable\u0026thinsp;+\u0026thinsp;1)). Assumptions of independence of residuals, multicollinearity, homoscedasticity, and normality of residuals were evaluated and met. Outliers were assessed using studentized residuals, leverage points, and Cook's distance, with no significant issues identified. Both unstandardized (B) and standardized (β) coefficients were reported to interpret the regression models. All analyses were performed using IBM SPSS Statistics for Windows, version 28.0 (IBM Corp., Armonk, NY). Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Sample characteristics and prevalence of Depression, Anxiety and PTSD after MI\u003c/h2\u003e \u003cp\u003eA total of \u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;199 took part in the survey; 43.2% were female and 56.8% were male, with a mean (\u0026plusmn;\u0026thinsp;\u003cem\u003eSD\u003c/em\u003e) age of 61.64 years (\u0026plusmn;\u0026thinsp;10.75). More than half (58.8%, \u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;117) of the sample reported psychological distress, with 37.7% meeting the cut-off for depression, 46.2% for anxiety, and 18.6% for PTSD. Female participants were disproportionately affected across all categories (see Table\u0026nbsp;1). Participants with anxiety had the highest rates of being affected of multiple MI (19.6%), and the most pronounced fear of death during MI (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;7.84, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.41). Illness perception was high across all distressed participants, with participants with PTSD showing the highest perceived threat (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;53.30, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;9.67). Social support was lowest for participants with PTSD (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;16.03, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6.02), while loneliness was highest for participants with depression (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6.04, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.00). Resilience and active stress coping were low among all distressed participants. Overall, psychosocial care during hospital stay after MI care during hospitalization for MI was perceived as insufficient. Among all MI patients, 34.2% reported having been asked about their wellbeing / mental health by hospital staff (Depression: 28.0%, Anxiety: 21.7%, PTSD: 24.3%). 15.1% reported being offered psychological help by hospital staff (Depression: 13.3%, Anxiety: 13.0%, PTSD: 16.2%), and only 11.1% reported being informed about the potential psychological effects of MI by hospital staff (Depression: 10.7%, Anxiety: 7.6%, PTSD: 8.1%). Only 7.0% of the participants reported being informed about counselling services in case of mental distress for mental health by hospital staff (Depression: 5.3%, Anxiety: 5.4%, PTSD: 2.7%). In Terms of history of illness, 19.6% of all participants reported a diagnosis of a mental disorder prior MI, while 16.1% were diagnosed after MI. 64.3% reported no diagnosis of a mental disorder.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable I\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eCharacteristics of participants\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003e(\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;199)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepression \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;75)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAnxiety \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;92)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePTSD \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;37)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003en (%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003en (%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003en (%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003en (%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSociodemographics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e86 (43.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (57.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50 (54.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (64.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113 (56.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (42.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42 (45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (35.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge in Years (\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61.64 (10.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.17 (10.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.77 (10.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58.89 (9.56)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo partner \u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41 (20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (26.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (26.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 (25.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartnership / married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (72.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67 (72.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (75.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo information\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (2.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMI\u003csup\u003ea\u003c/sup\u003e Event Characteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFear of death during MI \u003csup\u003ee, f\u003c/sup\u003e (\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.10 (3.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.84 (3.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.84 (2.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.62 (3.11)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResuscitation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (18.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (27.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e163 (81.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63 (84.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78 (84.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (73.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIllness perception (M, SD) \u003csup\u003eg\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42.96 (13.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.41 (10.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.37 (9.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.30 (9.67)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of Illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTiming of first MI \u003csup\u003ee\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 year ago\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (23.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (27.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (27.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;5 years ago\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66 (33.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (41.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (38.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (35.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;10 years ago\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38 (19.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (10.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years ago\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (13.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultiple MI \u003csup\u003ee\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (17.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 (18.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e165 (82.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74 (80.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30 (81.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnosis of mental disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBefore MI \u003csup\u003ee\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (30.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (35.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter MI \u003csup\u003ee\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (21.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e128 (64.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (49.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 (48.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (43.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerceived psychosocial care during hospital stay after MI \u003csup\u003ee\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff asked about wellbeing/ mental health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68 (34.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (28.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 (24.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131 (65.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (72.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28 (75.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff offered psychological help\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (15.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (16.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e169 (84.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80 (87.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31 (83.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff informed about the possible impact of MI \u003csup\u003ee\u003c/sup\u003e on mental health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (7.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (8.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e177 (88.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (89.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85 (92.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34 (91.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff informed about counselling services in case of mental distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (7.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e185 (92.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71 (94.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87 (94.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36 (97.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePsychosocial variables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial support \u003csup\u003eh\u003c/sup\u003e (\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.57 (5.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.84 (6.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.04 (5.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.03 (6.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLoneliness \u003csup\u003ei\u003c/sup\u003e (\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.81 (1.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.04 (2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.49 (1.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.62 (1.74)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResilience \u003csup\u003ej\u003c/sup\u003e (\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.99 (.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.68 (.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.61 (.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.78 (.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActive coping strategies \u003csup\u003ek\u003c/sup\u003e (\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.08 (2.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.88 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.03 (2.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.87 (2.45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression, Anxiety, PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScore\u0026thinsp;\u0026ge;\u0026thinsp;14 (\u003cem\u003en\u003c/em\u003e, \u003cem\u003e%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75 (37.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.39 (10.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScore\u0026thinsp;\u0026ge;\u0026thinsp;10 (\u003cem\u003en\u003c/em\u003e, \u003cem\u003e%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92 (46.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(\u003cem\u003eM\u003c/em\u003e, \u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.77 (9.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFulfilling criteria (\u003cem\u003en\u003c/em\u003e, \u003cem\u003e%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (18.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression, Anxiety and/or PTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e117 (58.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eNotes\u003c/em\u003e. M\u0026thinsp;=\u0026thinsp;Mean; SD\u0026thinsp;=\u0026thinsp;Standard deviation. \u003csup\u003ea\u003c/sup\u003e Depression assessed with depression scale of DASS-21; Score\u0026thinsp;\u0026ge;\u0026thinsp;14 (moderate depression). \u003csup\u003eb\u003c/sup\u003e assessed with anxiety scale of DASS-21; Score\u0026thinsp;\u0026ge;\u0026thinsp;10 (moderate anxiety). \u003csup\u003ec\u003c/sup\u003e assessed with ITQ. \u003csup\u003ed\u003c/sup\u003e Single, divorced, widowed. \u003csup\u003ee\u003c/sup\u003e Myocardial infarction. \u003csup\u003ef\u003c/sup\u003e scale ranging from 0 to 10, higher scores indicating a greater fear of death during MI; \u003csup\u003eg\u003c/sup\u003e assessed with BIP-Q. \u003csup\u003eh\u003c/sup\u003e assessed with ESSI. \u003csup\u003eI\u003c/sup\u003e assessed with UCLA 3-Item Loneliness Scale. \u003csup\u003ej\u003c/sup\u003e assessed with BRS. \u003csup\u003ek\u003c/sup\u003e assessed with SCI.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Relationship between Depression, Anxiety, PTSD after MI and characteristics of participants\u003c/h2\u003e \u003cp\u003eThe results of the Mann-Whitney U test indicate significant gender differences in depression, anxiety, and PTSD \u003cem\u003e(see Table\u0026nbsp;2)\u003c/em\u003e. Female participants reported significantly higher levels of depression (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), anxiety (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and PTSD (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) compared to male participants. Additionally, unpartnered individuals exhibited significantly (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05) higher scores in depression compared to those in relationships. Regarding the perceived psychosocial care during hospital stay after MI, the analysis revealed that individuals who were asked about their wellbeing / mental health showed significantly lower levels in depression (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05), anxiety (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and PTSD (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) than those who were not asked. Finally, Individuals with a diagnosis of a mental disorder prior to their MI showed higher levels in depression (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), anxiety (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and PTSD (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) than those diagnosed after the infarction or those without a psychological diagnosis.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable II\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eRelationship between psychosocial burden and characteristics of participants\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003ePTSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eMdn (IQR)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eM-W p\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eMdn (IQR)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eM-W p\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eMdn (IQR)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eM-W p\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSociodemographics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.0 (17.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.0 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.0 (10.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.0 (11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.0 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo partner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.0 (23.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.05\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.0 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.0 (8.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartnership / married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.0 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMI\u003csup\u003ea\u003c/sup\u003e Event Characteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResuscitation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.0 (17.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.0 (13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.5 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.0 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of Illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultiple MI \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.0 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.0 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.0 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnosis of mental disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBefore MI \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17.0 (18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.0 (18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.0 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter MI \u003csup\u003ea\u003c/sup\u003e or No diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.0 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerceived psychosocial care during hospital stay after MI \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff asked about wellbeing/ mental health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.0 (15.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.05\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.0 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.0 (9.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.0 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff offered psychological help\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.0 (16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.5 (14.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.0 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff informed about the possible impact of MI \u003csup\u003ea\u003c/sup\u003e on mental health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.0 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.0 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.0 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0 (15.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.0 (10.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff informed about counselling services in case of mental distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.0 (10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.0 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo / Unclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.0 (10.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNotes\u003c/em\u003e. M-W p\u0026thinsp;=\u0026thinsp;significance of Mann-Whitney U test; Mdn\u0026thinsp;=\u0026thinsp;Median; IQR\u0026thinsp;=\u0026thinsp;interquartile range. Significant results are in bold. \u003csup\u003ea\u003c/sup\u003e MI\u0026thinsp;=\u0026thinsp;myocardial infarction.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Multivariate associations between characteristics of participants and depression, anxiety and PTSD after MI\u003c/h2\u003e \u003cp\u003eTo evaluate the relationships between characteristics of participants and the psychological burdens after MI, multiple linear regression models were conducted (see Table\u0026nbsp;3). For depression, the multiple linear regression model explained 51.3% of the variance (\u003cem\u003eR\u0026sup2;\u003c/em\u003e = .513), with an adjusted \u003cem\u003eR\u0026sup2;\u003c/em\u003e of 46.9%. The model showed significant associations with depression (\u003cem\u003eF\u003c/em\u003e[16, 180]\u0026thinsp;=\u0026thinsp;11.827, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Illness perception had the strongest association (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.386, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.014, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Loneliness (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.228, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.059, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01) and age (\u003cem\u003eβ\u003c/em\u003e = \u0026minus;\u0026thinsp;.125, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.006, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05) were also significantly associated. For anxiety, the regression model accounted for 58.8% of the variance (\u003cem\u003eR\u0026sup2;\u003c/em\u003e = .588), with an adjusted R\u0026sup2; of 55.2%. The model indicated significant associations with anxiety (\u003cem\u003eF\u003c/em\u003e[16, 180]\u0026thinsp;=\u0026thinsp;16.076, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Illness perception emerged as the strongest association (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.535, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.018, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Fear of death during MI (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.117, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.024, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and experiencing multiple MIs (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.168, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.139, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01) were also significant. Diagnosis of mental disorder before MI and resuscitation were also significantly associated to anxiety (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.113, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.131, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05; \u003cem\u003eβ\u003c/em\u003e = \u0026minus;\u0026thinsp;.108, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.127, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05). Being unpartnered was also significantly associated with anxiety after MI (\u003cem\u003eβ\u003c/em\u003e = \u0026minus;\u0026thinsp;.105, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.118, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05). For PTSD, the model explained 58.4% of the variance (\u003cem\u003eR\u0026sup2;\u003c/em\u003e = .584), with an adjusted \u003cem\u003eR\u0026sup2;\u003c/em\u003e of 54.7%. Illness perception had the strongest association (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.371, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.012, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Age (\u003cem\u003eβ\u003c/em\u003e = \u0026minus;\u0026thinsp;.157, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.006, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01), loneliness (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.149, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.033, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05), and fear of death during MI (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.148, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.019, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01) were also significantly associated to PTSD. Respectively social support (\u003cem\u003eβ\u003c/em\u003e = \u0026minus;\u0026thinsp;.139, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.011, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05) was negatively associated with PTSD and multiple MI (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.122, \u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.140, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01) was positively associated with PTSD.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable III\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eMultiple linear Regression analysis on Depression (D-DASS-21), Anxiety (A-DASS-21) and PTSD (ITQ)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003ePTSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eCI (B)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eCI (B)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003eCI (B)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(Intercept)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.803*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[.09, 1.52]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.17, 1.02]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.586*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[.02, 1.15]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSociodemographics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.006*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.01, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.125*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.01, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.006**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.01, \u0026minus;\u0026thinsp;.00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.157**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex (female)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.10, .14]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.11, .08]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.10, .09]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship status (no partner)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.22, .06]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.118*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.24, \u0026minus;\u0026thinsp;.00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.105*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.16, .06]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.050\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMI\u003c/b\u003e \u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e \u003cb\u003eEvent Characteristics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFear of death during MI \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.02, .01]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.024**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[.01, .04]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.177**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.019**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[.01, .03]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.148**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResuscitation (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.24, .05]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.127*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.25, \u0026minus;\u0026thinsp;.01]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.108*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.14, .08]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePerceived psychosocial care during hospital stay after MI\u003c/b\u003e \u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff asked about wellbeing/ mental health (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.10, .15]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.17, .04]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.19, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.104\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff offered psychological help (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.26, .13]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.12, .19]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.06, .24]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff informed about the possible impact of MI \u003csup\u003ea\u003c/sup\u003e on mental health (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.10, .37]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.15, .23]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.11, .26]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStaff informed about counselling services in case of mental distress (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.46, .09]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.23, .23]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.38, .05]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.098\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHistory of Illness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultiple MIs \u003csup\u003ea\u003c/sup\u003e (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.02, .22]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.168**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[.05, .29]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.139**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.140**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[.03, .26]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.122**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnosis of mental disorder before MI \u003csup\u003ea\u003c/sup\u003e (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.10, .19]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.131*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[.01, .25]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.113*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.05, .18]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.057\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIllness Perception of heart disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.014***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[.01, .02]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.386***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.018***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[.01, .02]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.535***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.012***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[.01, .02]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.371***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePsychosocial factors\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.03, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.02, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.011*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.02, \u0026minus;\u0026thinsp;.00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.139*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLoneliness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.059**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[.02, .10]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.228**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.04, .02]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.033*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[.00, .06]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.149*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResilience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.03, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.02, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.02, .00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.099\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActive coping strategies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[-.02, .03]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[-.00, .03]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[-.01, .03]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.057\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e (adjusted \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e.513 (.469)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e.588 (.552)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003e.584 (.547)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNotes\u003c/em\u003e. Model = \"Inclusion\" method in SPSS Statistics; B\u0026thinsp;=\u0026thinsp;Non-standard regression coefficient. CI (B)\u0026thinsp;=\u0026thinsp;95% confidence interval for B; The CI was rounded to the second decimal place; SE(B)\u0026thinsp;=\u0026thinsp;standard error of coefficient B; β\u0026thinsp;=\u0026thinsp;standardised coefficient; Depression, Anxiety, PTSD: log10-transformed; *p\u0026thinsp;\u0026lt;\u0026thinsp;.05. **p\u0026thinsp;\u0026lt;\u0026thinsp;.01. ***p\u0026thinsp;\u0026lt;\u0026thinsp;.001. \u003csup\u003ea\u003c/sup\u003e MI\u0026thinsp;=\u0026thinsp;myocardial infarction.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe present study aimed to investigate the psychological burden of MI, identify associated factors for depression, anxiety, and PTSD, and gain insights into the perceived psychosocial care during hospital stay after MI. The findings revealed that more than half of the participants suffer from depression, anxiety, and/or PTSD. Still, only up to one third of participants received psychosocial care during hospitalization. Multivariate analysis showed that a threatening illness perception was associated with depression, anxiety, and PTSD. Additionally, younger age and loneliness were linked to depression and PTSD, while multiple MIs and fear of death were associated with anxiety and PTSD. Anxiety was further related to a history of mental disorders, no resuscitation, and being with no partner, whereas PTSD was significantly associated with low social support.\u003c/p\u003e \u003cp\u003eThe prevalence rates of the psychological burden observed in the present sample were higher than in previous research [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan additionalcitationids=\"CR18 CR19\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], particularly for depression and anxiety. This discrepancy may have occurred due to differences in assessment timing, as prior studies often collected data during hospitalization [e.g. 18], whereas this study recruited participants online with varying MI histories. Factors such as differences in assessment methods, sample characteristics (e.g., age distribution, socioeconomic status, and pre-existing mental health conditions) or the possibility of prolonged psychological distress accumulation, may explain the higher prevalence found. Regarding sociodemographic factors, age was negatively associated with depression and PTSD, suggesting a greater psychological burden in younger individuals. A possible explanation for this finding is that younger individuals are less prepared to cope with serious health events like MI, and may experience heightened existential anxiety related to career, family, or future plans, which could exacerbate psychological distress. Moreover, being without a partner also emerged as an important factor, significantly associated with anxiety after MI. The absence of a partner may contribute to an increased psychological burden due to reduced emotional and practical support in coping with different (life-threatening) events. This finding aligns with the broader pattern observed in this study, where social factors play a crucial role in psychological burden. While these findings are in line with prior research [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan additionalcitationids=\"CR50\" citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], other psychosocial factors such as resilience and active stress coping did not show significant association with the psychological burden compared to prior research [\u003cspan additionalcitationids=\"CR54 CR55 CR56 CR57 CR58\" citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Further, a threatening illness perception was significantly associated with psychological burden after MI, while fear of death was significantly linked to anxiety. These associations align with findings widely discussed in the literature, underscoring the crucial role of subjective perceptions of illness severity in shaping psychological outcomes following MI [\u003cspan additionalcitationids=\"CR43 CR44 CR45 CR46 CR47\" citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. An unexpected finding of the present study was that participants who did not underwent resuscitation exhibit significantly higher anxiety than those who underwent resuscitation, contradicting the findings of prior studies [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. A possible explanation could be that resuscitated patients received more intensive care and post-event monitoring, providing reassurance and potentially reducing anxiety. Additionally, the extreme nature of resuscitation might have prompted more social support. In contrast, patients who did not undergo resuscitation may have experienced greater uncertainty and received less social support, leading to higher anxiety. This highlights the need for psychological screenings in all MI patients, not just those with severe medical conditions requiring resuscitation. Consistent with previous research [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], a history of mental disorders prior to MI was found to be a significant factor for anxiety after MI. Moreover, despite the high prevalence of psychological burden, most participants lacked an official diagnosis, suggesting that the mental health of cardiac patients might be often overlooked. In addition to these findings, only a small proportion of participants reported to have received psychosocial care during hospitalization, which is in line with previous research [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27 CR28 CR29 CR30 CR31 CR32 CR33\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. While about one third of participants stated that staff asked about wellbeing / mental health further psychosocial support\u0026mdash;such as offering of psychological help, information on the psychological impact of MI, and information about counselling services in case of psychological distress\u0026mdash;were even more infrequent. Finally, the analysis of the relationship between depression, anxiety, PTSD and the characteristics of the participants revealed a significant difference between individuals who were asked about their mental health during the hospital stay and those who were not. Specifically, those who received such an inquiry reported lower levels of depression, anxiety, and PTSD. However, multivariate analysis found no significant impact of psychosocial care during hospitalization on psychological burden.\u003c/p\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Limitations\u003c/h2\u003e \u003cp\u003eThis study has several limitations that should be considered. The cross-sectional design provides only a snapshot of individuals' mental health, limiting the ability to draw conclusions about long-term effects or developmental trajectories. As a result, the findings reflect associations rather than causal relationships. Additionally, the reliance on self-reported data introduces potential biases, such as social desirability effects and recall inaccuracies, which may affect the reliability of the responses. The limited sample size may also lead to underrepresentation of certain population subgroups, limiting the generalizability of the results. Moreover, participants with a history of multiple MIs were instructed to focus on the most severe event. While this approach was intended to capture the most intense psychological responses\u0026mdash;acknowledging the significant role of subjective experience in conditions like depression, anxiety, and PTSD\u0026mdash; it may have introduced inconsistencies in data collection. Since participants could select different reference points (e.g., the first MI vs. the most severe MI in case of multiple Mis in the past), this variability could affect comparability across individuals and potentially influence the overall findings. Using a standardized reference point, such as consistently analyzing the first MI, might have yielded different results. Despite these constraints, the study provides valuable insights into the psychological impact of MI and highlights the significance of subjective experiences in understanding mental health outcomes. Future research using longitudinal designs and additional clinical assessments could strengthen these findings and offer a more comprehensive understanding of mental health trajectories in this population.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Conclusion\u003c/h2\u003e \u003cp\u003eIn summary, this study highlights the significant psychological burden experienced by individuals following MI, particularly in terms of depression, anxiety, and PTSD. These findings emphasize the need for more comprehensive psychosocial support during hospitalization, addressing not only the psychological aspects of recovery but also the social and demographic factors that contribute to mental health outcomes. The study underscores the importance of integrating mental health care into routine cardiovascular treatment, as recommended by the European Society of Cardiology. Early identification and management of psychosocial distress, including targeted interventions for factors such as loneliness, illness perception, and pre-existing mental health conditions, are essential for improving both psychological and medical recovery. These insights contribute to the growing understanding of the cardiovascular-mental health connection and provide a foundation for developing more holistic and effective care strategies moving forward.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBIP-Q\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Brief Illness Perception Questionnaire\u003c/p\u003e\n\u003cp\u003eBRS\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Brief Resilience Scale\u003c/p\u003e\n\u003cp\u003eCVD\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Cardiovascular Disorders\u003c/p\u003e\n\u003cp\u003eESSI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;ENRICHD Social Support Inventory\u003c/p\u003e\n\u003cp\u003eITQ\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;International Trauma Questionnaire\u003c/p\u003e\n\u003cp\u003eIQR\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Interquartile range\u003c/p\u003e\n\u003cp\u003eM\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Mean\u003c/p\u003e\n\u003cp\u003eM-W\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Mann-Whitney-U-Test\u003c/p\u003e\n\u003cp\u003eMdn\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Median\u003c/p\u003e\n\u003cp\u003eMI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Myocardial Infarction\u003c/p\u003e\n\u003cp\u003ePTSD\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Posttraumatic Stress Disorder\u003c/p\u003e\n\u003cp\u003eREDCap\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Research Electronic Data Capture\u003c/p\u003e\n\u003cp\u003eSCI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Stress-and Coping-Inventory\u003c/p\u003e\n\u003cp\u003eSD \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Standard Deviation\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe online survey was approved by the ethics committee of the Faculty of Medicine of the Charité – Universitätsmedizin Berlin (reference number:\u0026nbsp;EA2/052/24). The study adhered to the Declaration of Helsinki. All data were provided and analyzed anonymously. All respondents provided written informed consent for participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset of the survey is available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo competing interests declared.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted at the Friede Springer – Cardiovascular Prevention Center (FS-CPC) which is funded by the Friede Springer Foundation (https://www.friedespringerstiftung.de/). The source has no implications for the conduct, and the results reported in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors contributed to the article as follows: CS curated, analyzed the data, interpreted and visualized the data and wrote the main manuscript text. CS and CH developed the methodology, implemented software, and led the project administration. PG, EST, UL, MR, and SD assisted with supervision and resources. All authors contributed to initial draft of the manuscript and have approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank all survey participants and the German Heart Foundation (Deutsche Herzstiftung e.V.) for supporting the study.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBenziger CP, Roth GA, Moran AE. 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Correlations among psychological resilience, self-efficacy, and negative emotion in acute myocardial infarction patients after percutaneous coronary intervention. \u003cem\u003eFront Psychiatry\u003c/em\u003e. 2018;9:1. doi: 10.3389/fpsyt.2018.00001.\u003c/li\u003e\n \u003cli\u003eKirchner K, Brauer H, Van der Auwera S, Grabe HJ.\u0026nbsp;The impact of resilience, alexithymia and subjectively perceived helplessness of myocardial infarction on the risk of posttraumatic stress.\u003cem\u003e\u0026nbsp;J Clin Psychol Med Settings\u003c/em\u003e. 2022;29(4):945-962. doi:10.1007/s10880-022-09857-w.\u003c/li\u003e\n \u003cli\u003eMeister RE, Princip M, Schnyder U, Barth J, Znoj H, Schmid JP, et al.\u0026nbsp;Association of trait resilience with peritraumatic and posttraumatic stress in patients with myocardial infarction. \u003cem\u003ePsychosom Med\u003c/em\u003e. 2016;78(3):327-334. doi: 10.1097/PSY.0000000000000278.\u003c/li\u003e\n \u003cli\u003eFarnia V, Bahremand M, Moradi S, Mosavi SA, Alikhani M. Relationship between coping strategies and perceived social support with stress, depression and anxiety in people with coronary heart disease. \u003cem\u003eSoc Sci\u003c/em\u003e. 2016;11(6):837-841.\u003c/li\u003e\n \u003cli\u003eChauvet-Gelinier JC, Bonin B. Stress, anxiety and depression in heart disease patients: A major challenge for cardiac rehabilitation. \u003cem\u003eAnn Phys Rehabil Med\u003c/em\u003e. 2017;60(1):6-12. doi: 10.1016/j.rehab.2016.09.002.\u003c/li\u003e\n \u003cli\u003eDollenberg A, Moeller S, L\u0026uuml;cke C, Wang R, Lam AP, Philipsen A, et al. Prevalence and influencing factors of chronic post-traumatic stress disorder in patients with myocardial infarction, transient ischemic attack (TIA) and stroke \u0026ndash; an exploratory, descriptive study. \u003cem\u003eBMC Psychiatry\u003c/em\u003e. 2021;21(1):295. doi:10.1186/s12888-021-03303-1\u003c/li\u003e\n \u003cli\u003eNilges P, Essau C. 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The brief resilience scale: assessing the ability to bounce back. \u003cem\u003eInt J Behav Med\u003c/em\u003e. 2008;15(3):194-200. doi:10.1080/10705500802222972\u003c/li\u003e\n \u003cli\u003eSatow L. Stress- und Coping-Inventar (SCI): Test- und Skalendokumentation (2., \u0026uuml;berarbeitete und neunormierte Version). 2024.\u0026nbsp;Available online: https://www.drsatow.de/tests/stress-und-copinginventar/.\u003c/li\u003e\n \u003cli\u003eSatow L. Stress- und Coping-Inventar (SCI): Testmanual und Normen (2., \u0026uuml;berarbeitete und neunormierte Version). 2024. Available online: https://www.drsatow.de/tests/stress-und-coping-inventar/\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"cardiovascular disease, heart attack, psychosocial burden, PTSD, psychosocial care ","lastPublishedDoi":"10.21203/rs.3.rs-6601928/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6601928/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eMyocardial infarctions (MI) significantly contribute to the global disease burden and are often followed by psychological conditions such as depression, anxiety, and posttraumatic stress disorder (PTSD). These are frequently underrecognized and insufficiently addressed in clinical care. This study aims to investigate the psychosocial impact of MI, identify risk factors for psychological burden following an MI, and gain insight into the perceived psychological care during hospitalization.​\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA population-based online survey (\u003cem\u003eN\u003c/em\u003e=199 MI patients) was conducted between May 15th and August 1st, 2024. Standardized instruments included Depression Anxiety Stress Scale-21 (DASS-21), International Trauma Questionnaire (ITQ), Brief Illness Perception Questionnaire (B-IPQ), ENRICHD Social Support Inventory (ESSI), UCLA 3-Item Loneliness Scale, Brief Resilience Scale (BRS), and Stress-and Coping-Inventory (SCI). Multiple linear regression models examined associations between psychological burden, psychosocial factors, MI event characteristics, illness perception, history of illness, and perceived psychosocial care during hospitalization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/em\u003eMore than half (58.8%) of MI patients experienced at least one psychological burden, with 37.7% meeting criteria for depression, 46.2% for anxiety, and 18.6% for PTSD. Additionally, 65.9% reported not to be asked about their mental health during hospitalization. Depression was significantly associated with illness perception (β = .386), loneliness (β = .228) and age (β = -.125). Anxiety was associated with illness perception (β = .535), multiple MIs (β = .168), fear of death (β = .117), prior diagnosis of mental disorder (β = .113), resuscitation (β = -.108) and having no partner (β = -.105). PTSD was linked to illness perception (β = .371), age (β = -.157), fear of death (β = .148), multiple MIs (β = .122), loneliness (β = .149), and social support (β = -.139).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/em\u003eThe findings emphasize the psychological burden following MI and the need for their systematic screening in cardiology to improve patient care.\u003c/p\u003e","manuscriptTitle":"Depression, anxiety, posttraumatic stress disorder and perceived psychosocial care during hospital stay after myocardial infarction: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-02 02:41:28","doi":"10.21203/rs.3.rs-6601928/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-23T12:35:23+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-20T23:12:17+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-18T20:00:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"269528160626986139617573700828958211266","date":"2025-06-11T12:21:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"305565085835090571158143322897137864716","date":"2025-06-10T15:45:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"285744506207636265152507802058487300382","date":"2025-06-10T15:33:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-29T11:14:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-29T11:14:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-16T07:47:09+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-15T11:31:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2025-05-15T11:30:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bdb817b9-25dd-445e-9301-c8435a279f81","owner":[],"postedDate":"June 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-15T16:01:34+00:00","versionOfRecord":{"articleIdentity":"rs-6601928","link":"https://doi.org/10.1186/s12872-025-05129-1","journal":{"identity":"bmc-cardiovascular-disorders","isVorOnly":false,"title":"BMC Cardiovascular Disorders"},"publishedOn":"2025-09-08 15:57:16","publishedOnDateReadable":"September 8th, 2025"},"versionCreatedAt":"2025-06-02 02:41:28","video":"","vorDoi":"10.1186/s12872-025-05129-1","vorDoiUrl":"https://doi.org/10.1186/s12872-025-05129-1","workflowStages":[]},"version":"v1","identity":"rs-6601928","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6601928","identity":"rs-6601928","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}